Inside Health

Gateses Give $47 Million to Bolster Coordinated Assaults on Diseases

By CELIA W. DUGGER

Published: December 20, 2006

The Bill & Melinda Gates Foundation is giving $47 million in grants for the control of neglected tropical diseases, now almost forgotten in wealthy nations, that still cause excruciating pain, disfigurement and disability for millions of the world's poorest people, the recipients announced yesterday.

The grants are unusual in that they do not single out individual diseases. Instead, they aim to test the idea that diseases such as trachoma, river blindness, lymphatic filariasis and hookworm, which largely afflict the rural poor, can be tackled together more effectively and cheaply than one at a time.

The groups that received the grants estimated that the cost of providing drugs to control a handful of the most devastating diseases could be as little as 50 cents per person if the efforts were well coordinated. Pharmaceutical companies donate a number of the drugs needed for such an assault on disease, helping to reduce the price tag.

Dr. Regina Rabinovich, the foundation's director of infectious diseases, said she was struck some years back that each disease had its own champions operating largely in isolation from one another. ''They were running around treating the same population with overlapping sets of drugs,'' she said.

Attempts to break the habit of building international efforts around individual diseases are gaining popularity in Africa. For example, campaigns to immunize children for measles are now also distributing mosquito nets to prevent malaria.

The Gates Foundation is hoping to encourage similar efficiencies for tropical diseases that infect more than two billion people globally, but that have had trouble competing for money with the big infectious-disease killers like AIDS, tuberculosis and malaria.

The Carter Center, based in Atlanta, will use much of its $10 million in grants in Nigeria to work simultaneously on river blindness, lymphatic filariasis (often called elephantiasis), schistosomiasis (snail fever) and trachoma, which can lead to blindness and disabling pain as eyelashes turn in on the eyeball.

The New York-based International Trachoma Initiative received $10 million to develop a model in Mali for a combined effort against trachoma and lymphatic filariasis, a disease in which worms nest in the lymph system, eventually causing grotesquely swollen legs and scrotums.

The Schistosomiasis Control Initiative, based at the Imperial College London, the Task Force for Child Survival and Development in Atlanta and the World Health Organization in Geneva also received grants.

Dr. Rabinovich said she hoped the groups could develop new strategies for taking on these hidden, overlooked scourges. ''These are diseases of Biblical proportions,'' she said, ''and should remain in the Bible.''